Thyroid Cancer Diagnosis and Prognosis

The thyroid is a butterfly-shaped gland in the throat surrounded by the parathyroid glands and controlled by the pituitary gland in the brain. It releases hormones that control the metabolism throughout the body. Many people develop a nodule on the thyroid, and in some cases this nodule becomes cancerous. Since it can be difficult to notice an internal lump, it may take some time for the nodule to be recognized. The sooner it is, however, the better the chances for treatment, recovery, and preventing recurrence or spreading of the cancer.

If you’ve noticed pain or a lump in your throat (whether by touch or visibly, as some thyroid cancers can be visible under the skin, like a goiter); swollen lymph nodes; your voice has changed; or difficulty swallowing or breathing, it’s probably time to go to the doctor.

Testing

To begin the diagnostic process, your physician will perform a physical exam. He or she will also want to know if you have been exposed to a lot of radiation (even a long time ago) or if anyone in your family has thyroid cancer. Blood tests are the next step; these check the thyroid hormone levels in the body, to see if it is producing normally. Specifically, the thyroid-stimulating hormone (TSH), serum calcitonin, and carcinoembryonic antigen (CEA) levels will be looked at.

Using a laryngoscope, a thin tube with a light and camera on the end, your doctor can look down your throat to see how your vocal cords look. If the initial testing suggests something is definitely wrong, the next step is a biopsy. An extremely thin needle is pushed through the skin and into the nodule, using ultrasound imaging to see what’s going on internally. A tiny piece of tissue is removed and then analyzed for abnormal cells.

Computerized tomography (CT), positron emission tomography (PET), and ultrasounds are imaging tests that show if the lump on the thyroid is a nodule (solid) or a cyst (fluid filled), and if there is more than one.

Prognosis

The sooner thyroid cancer is detected, the better the chances are of removing it, keeping it from spreading, and preventing it from returning. Additionally, the younger you are, the better your prognosis.

The type of thyroid cancer present has much to do with the chances of getting better. The four kinds are papillary, follicular, medullary, and anaplastic. Papillary accounts for 80% of thyroid cancers and follicular for another 15%; it may not seem like it, but this is a good thing. Both of these cancers have a cure rate of 97%. Medullary cancers are a little different from the rest in their makeup; they only account for 3% of thyroid cancers, but they spread very quickly. Even still, they have a very high ten year survival rate, although this drops significantly as the cancer spreads. Only 1% of thyroid cancers are anaplastic, but they have the worst prognosis. Even with excellent treatment, patients often look at less than a year before the tumor becomes fatal.